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在腹腔镜袖子胃切除术和后肠手术后的2型糖尿病缓解:一项回顾性多中心研究
Diego Foschi1, Giuliano Sarro2, Micaela Serbelloni2
1Institute San Gaudenzio, Via Enrico Bottini 3, 28100, Novara, Italy. diego.foschi@unimi.it.
Updates in surgery
|November 27, 2024
概括
对于患有肥胖和2型糖尿病 (T2DM) 的患者,袖子胃切除术 (SG) 与后肠手术相结合,可以提供比单独SG更好的长期代谢控制. 这种方法在3-5年后显著降低T2DM复发率.
科学领域:
- 腹部外科 腹部外科
- 代谢手术 代谢手术
- 内分泌学 在内分泌学.
背景情况:
- 袖子胃切除术 (SG) 是一种标准的减肥手术,具有良好的结果.
- 然而,单独的SG在患有肥胖和2型糖尿病 (T2DM) 的患者中具有代谢失败的高风险.
- 将SG与前肠或后肠程序相结合可能会改善代谢结果,但直接比较是有限的.
研究的目的:
- 为了比较单独的SG与SG与基于后肠手术的SG在肥胖和T2DM患者的腹和代谢效应.
- 为了评估体重减轻,血糖控制和T2DM缓解率在手术后3-5年.
主要方法:
- 追溯性研究比较了四组:SG (n=20),SG与十二指甲骨转移和阴茎间接 (SG-DD-II,n=20),SG与十二指甲骨-阴茎缩 (SADI-S,n=20),和SG与单次胃缩 (SASI-S,n=20).
- 收集的数据包括人体测量和T2DM特征.
- 评价标准:体重减轻的百分比,空腹血糖 (FGL),糖化血红蛋白 (HbA1C) 和T2DM缓解率.
主要成果:
- 所有手术都显示了可接受的短期体重减轻和T2DM缓解.
- 在3年和5年后,单独使用SG的T2DM复发率明显高于以后肠为基础的手术.
- 基于肠的程序显示出优越的长期代谢结果.
结论:
- 在肥胖和T2DM患者中,建议将袖子胃切除术与基于后肠的手术结合起来.
- 这种综合方法显著降低了2型糖尿病的长期复发率.
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